Patient Safety Blog - Lubin & Meyer PC

9.11.2017

What is sepsis?

Sepsis is the body’s extreme response to an infection. It is life-threatening, and without timely treatment, sepsis can rapidly cause tissue damage, organ failure, and death. According to information compiled by the Sepsis Alliance, sepsis is the leading cause of death in U.S. hospitals.

Who is at risk for sepsis?

Anyone can get an infection, and almost any infection can lead to sepsis. It is also sometimes called "blood poisoning". Those with chronic conditions such as diabetes, lung disease, cancer, and kidney disease, are at higher risk of developing infections that can lead to sepsis. (See list of other diseases and conditions related to sepsis.)

At highest risk of developing sepsis are those:

Age 65 and older

Age 1 and younger

With Chronic medical conditions (stated above)

With weakened immune systems.

What are the symptoms?

There is no single symptom of sepsis. Symptoms of sepsis can include a combination of any of the following:

Confusion or disorientation

Shortness of breath

High heart rate

Fever, or shivering, or feeling very cold

Extreme pain or discomfort

Clammy or sweaty skin.

Get medical help immediately if you suspect sepsis, or if your infection is not getting better or is getting worse.

What to do if you suspect sepsis?

Sepsis is a medical emergency. Time matters. Call your doctor or go to the emergency room immediately if you suspect sepsis.

It’s important that you ask, “Could this be sepsis?”

If you are continuing to feel worse or not getting better in the days after surgery, ask your doctor about sepsis.

If you have an infection and don’t get better or start feeling worse, ask your doctor, “Could this infection be leading to sepsis?”

8.01.2017

The Boston Globe's Liz Kowalczyk exposes a worrisome trend — an increase in the maternal mortality rate — in her July 30 article in response to the deaths of two expectant women in labor and delivery at MetroWest Medical Center in Framingham, Massachusetts.

Lubin & Meyer represents the family at the center of the Globe’s exposé.

“In the year 2017, the high incidence of maternal death that exists is unacceptable and is often due to the carelessness and lack of attention from medical professionals. Higher standards and continued reporting of incidences will be the only solution to this ever growing tragic problem.”

Maternal Deaths Rising in U.S.

Regarding the prevalence of maternal deaths, the article states:

"The rate of women dying from pregnancy-related causes has climbed in the United States in recent years, even as it has fallen globally. The reasons are unclear, but it may be due to the growing number of American women with chronic health problems such as diabetes, obesity, and heart disease that put them at higher risk.

The Centers for Disease Control and Prevention recently put the national rate at about 17 women per 100,000 live births. The World Health Organization said the US rate is higher than that of countries including Canada, France, Germany, Great Britain, Greece, Ireland, Italy, and Spain."

Here in Massachusetts the rate is historically below the national average. As stated in article: "6.9 deaths per 100,000 live births, according to the health department’s most recent data."

"[Massachusetts] is one of the few states where public health officials study the medical records and autopsy reports for every woman who dies, to pinpoint causes. If they find her death could have been prevented with better medical care, the department requires hospitals to improve their procedures. They believe at least one-quarter of deaths are preventable."

The family's lawsuit claims that based on her medical records, she was not given proper care. As stated in the article:

"Her blood was not tested at regular intervals to look for a worsening of her condition, and she was not given medication to manage her high blood pressure, they said. And physicians decided to perform a caesarean section only when the baby developed an abnormal heart rhythm."

7.14.2017

Less invasive laparoscopic gallbladder surgery has record of serious medical mistakes

Removal of the gallbladder is a common surgery (also known as cholecystectomy) and is either performed as an “open” surgery where a surgeon removes the gallbladder through a large incision, or as a less invasive “laparoscopic” procedure. During laparoscopic gallbladder surgery, a tiny video camera and specialized surgical tools are inserted through four small incisions in the abdomen. The procedure is very common, but serious errors are possible when proper care is not taken by the surgeon when operating in this very tight space.

“Laparoscopic gallbladder surgery is a less invasive outpatient surgery with a faster recovery than open gallbladder surgery, however it still carries grave risks when the standard of care is not followed by the surgeon to properly identify nearby anatomy.”

While the risks are low, it is extremely important that the surgeon properly identifies the gallbladder and closely situated anatomy such as bile duct and blood vessels to avoid possibility of cutting, perforating or nicking any other areas with the surgical tools while removing the gallbladder. Doing so can result in symptoms of pain and stomach problems, subsequent infection and the need for a second surgery to correct the problems. If the botched surgery is not diagnosed in time it can lead to severe complications and even death.

Injuries to adjacent anatomy during gallbladder removal can include the:

bile duct

hepatic duct

intestines

bowel

blood vessels.

Results of such injuries can results in:

bile leakage into abdomen

infection

additional invasive surgery

blood loss and organ damage

unseen complications.

What to do if you had gallbladder surgery complications

If you believe you may have complications resulting from laparoscopic gallbladder surgery, you should seek immediate medical attention.

If indeed you suffered injuries related to gallbladder surgery, and required additional medical care, there may have been negligence in the performance of your surgery and you may have a valid medical malpractice claim.

Recent verdicts and settlements

Below are a few of Lubin & Meyer's gallbladder medical malpractice lawsuits that serve as illustrative examples the types of possible injuries.

If
you have any questions about the quality of care you received, please
do not hesitate to call us for a free case evaluation. We represent
patients in Massachusetts, New Hampshire and Rhode Island. There is no
fee to review your case, and you do not pay us unless we recovery money
for you.

5.10.2017

Check Your Hospital's Latest Safety Report Card

The Leapfrog Hospital Safety Grade was launched in 2012 to help increase awareness of hospital errors, injuries, accidents and infections. Since 2012, the Leapfrog Group has been assigning A, B, C, D and F letter grades to more than 2,600 acute-care hospitals nationwide, twice a year.

The score is based on the Leapfrog Hospital Survey along with national performance measures from the Centers for Medicare & Medicaid Services, the Agency for Healthcare Research and Quality (AHRQ), and the Centers for Disease Control and Prevention (CDC), and the American Hospital Association’s Annual Survey and Health Information Technology Supplement.

The Need to Focus on Injuries, Accidents and Infections

Often-cited industry statistics reported on the Leapfrog website drive home the need to focus on patient safety.

Approximately 1,000 people die each day due to a preventable hospital error

1 in 25 patients develops an avoidable infection while in the hospital

1 in 4 Medicare patients will experience injury, harm or death when admitted to a hospital

Some of the most important measures according to the Leapfrog Group are listed here.

“Our goal was to alert consumers to the hazards involved in a hospital stay and help them choose the safest option. We also hoped to galvanize hospitals to make safety the first priority day in and day out. So far, we’ve been pleased with the increase in public awareness and hospitals’ commitment to solving this terrible problem. But we need to accelerate the pace of change, because too many people are still getting harmed or killed.”

1. Speak Up. Talk to your doctor about infection and what they are doing to protect you.

3. Monitor Antibiotics. Ask if a test will be done to make sure the right antibiotic is prescribed.4. Watch for Infection.
Some skin infections, such as MRSA, appear as redness, pain, or
drainage at an IV catheter site or surgery site. Sometimes these symptoms
come with a fever. Tell your doctor if you have these symptoms.

5. Monitor Diarrhea. Tell your doctor if you have 3 or more diarrhea episodes in 24 hours.

6. Vaccinate. Get vaccinated against flu and other infections to avoid complications.

Know Your Patient Rights

These rights are part of The Health Insurance Portability and Accountability Act of 1996 (HIPAA). In most cases, your health provider must give you your records within 30 days. If your information is not maintained or accessible on-site, it may take up to 60 days. There are some exceptions that may require an extension, and in a few special cases, you may not be able to receive all of your information. For the finer points please see: Your Health Information Rights.

Described as the "go to guy" for families in Massachusetts, New Hampshire and Rhode Island, who have experienced devastating injuries due to medical negligence," he has built a
career by giving a voice to those who have been harmed by the medical
community."

In the article, Meyer discusses the important role that he and his medical malpractice law firm play as a watchdog to a medical system that sets its own standards and regulates itself.

"There is nowhere that a family harmed by the medical
community can go, other than to an attorney. The medical industry
establishes their own rules and standards of care. The boards and
societies that oversee the medical community are funded by and run by
people within the medical profession. Small changes have
been instituted these past years, but it’s simply not enough."
— Drew Meyer

The author, Stacey Alcorn, describes him as "a champion for the innocent, lending a hand to those in need by
giving them a voice against a community that will do anything to stamp
it out."

Meyer provides some important parting advice — that each individual must be his or her own best
advocate.

"When it comes to your own medical care or that
of a loved one, speak up, be an aggressive consumer, and understand that
you know your own body better than any medical professional."

12.09.2016

Boston Globe Spotlight Team and Lubin & Meyer lawsuits have been at the center of widening awareness of this patient safety issue

Senate Finance Committee Chairman Orrin Hatch (R-Utah) and Ranking
Member Ron Wyden (D-Ore.) issued a committee staff report
detailing the practices of concurrent and overlapping surgeries where
lead doctors at teaching hospitals perform multiple surgeries at the
same time.

“Concurrent and Overlapping Surgeries: Additional Measures Warranted,”
outlines a number of shortfalls at the federal level in monitoring and
auditing teaching hospitals to ensure they are in compliance with
Medicare billing restrictions, while also making a number of
recommendations for hospitals and regulators to ensure patient safety
and improve transparency.

“This report provides a crucial look
at the little-known practices of concurrent and overlapping surgeries
and lays the groundwork for improving the system moving forward,” Hatch
and Wyden said, “While we are encouraged by the steps taken by the
American College of Surgeons and a number of hospitals to address the
concerns with concurrent surgeries, we remain concerned that the nearly
5,000 hospitals in America may lack thorough and complete policies
covering these procedures and patient consent. By working with
hospitals and surgeons in a collaborative manner, it is our hope we can
continue to increase transparency and patient safety.”

Largely unknown, the practice of double-booking surgeries was made public through an investigative report by the Boston Globe's Spotlight Team involving the concurrent surgeries at Massachusetts General Hospital and two patients represented by Lubin & Meyer who filed lawsuits claiming injuries due to the practice of one surgeon with overlapping surgeries.

11.10.2016

Massachusetts is well known as home to some of the world's most prestigious hospitals, such as Mass. General Hospital and Children's Hospital both recently named among the "Top Hospital in the Nation" by U.S. News & World Report and Best Hospitals.® However, even here in Massachusetts, serious medical mistakes continue to happen to far too many patients while in the hospital.

As a follow up to last year's post on Massachusetts Hospital Errors, we have updated our reporting to include new data (from 2015) that hospitals and surgery centers are required to report to the Department of Public Health documenting Serious Reportable Events or SREs. There are 29 such events, also known in hospitals as "Never Events," and we list them here with the total instances reported by the state's acute care hospitals in 2015. For similar information on non-acute care hospitals and ambulatory surgery centers please see the The Massachusetts Health and Human Services website for that publicly available information.

While the total number of SREs in acute care hospitals increased in 2015 (up from 89 in 2013; 82 in 2014; and 1,254 in 2015), most of the increase in 2015 was due to a spike in cases of contaminated drugs, devices or biologics, with most of those accountable to one hospital — Baysate Medical Center in Springfield, MA, where patients were exposed to infection due to unsanitary conditions in the inpatient dialysis unit. Patient safety efforts at hospitals aim at reducing errors, but still too many errors are happening.

In addition to the contamination events, topping the list of hospital errors in Massachusetts are:

Potential Criminal Events26. Impersonation of a health care provider = 027. Abduction of patient = 028. Sexual abuse or assault of patient or staff member = 929. Serious injury or death after physicial assault of patient or staff = 21

How Did Your Hospital Do? For a hospital-by-hospital tabulation of the most recent “never event” medical errors, please visit the mass.gov website’s Serious Reportable Events page.

Hospitals and ambulatory surgery centers are required by law to report SREs to the Massachusetts Department of Public Health. The law also prohibits hospitals from charging for these events or seeking reimbursement for SRE-related services.

9.15.2016

What is Sepsis?

Sepsis is the body’s overwhelming and life-threatening response to an infection, which can lead to tissue damage, organ failure, and death. Sometimes called blood poisoning, it can be caused by a seemingly minor infection due to a scrape or cut. It is often the cause of death of people suffering from other diseases (see Sepsis and Other Diseases). For instance, people with cancer can die as the result of the actual tumor or from an associated condition such as sepsis. Anyone can get sepsis but children and older adults tend to be more vulnerable.

Know the signs and symptoms of Sepsis

There is no single sign or symptom of sepsis. It is a combination of symptoms. And because sepsis is the result of an infection, symptoms can include signs of infection such as diarrhea, vomiting, sore throat, etc.) in addition to ANY of these symptoms:

What to do if you suspect Sepsis

Sepsis should be treated as a medical emergency (as quickly as possible) with antibiotics and fluids. If you think you or a loved one has sepsis you should be clear and firm that you suspect sepsis and demand urgent attention.

Call your doctor or go to the emergency room immediately if you have any signs or symptoms of an infection or sepsis. This is a medical emergency.

It’s important that you say, “I AM CONCERNED ABOUT SEPSIS.”

If you are continuing to feel worse or not getting better in the days after surgery, ask your doctor about sepsis. Sepsis is a common complication of people hospitalized for other reasons.

According to an op-ed in the New York Times, most medical guidelines recommend men weigh the benefits and limitations of PSA screening. However, in 2012, the U.S. Preventive Services Task Force recommended against prostate-specific antigen (PSA)-based screening for prostate cancer.

The op-ed reported:

"The government guidelines stunned doctors who recognize the greater dangers of prostate cancer in African-American men. Many believe that the disadvantages of routine PSA screening are outweighed when it comes to high-risk populations, and they worry that the guidelines will lead to less screening for men who might benefit the most from it. Their concerns have been borne out: Recent studies note a decrease in PSA screening for all populations, including African-American men."

The American Cancer Society recommends men discuss the risks and benefits of PSA tests with their doctors — starting at age 45 for black men or younger for men with family history of prostate cancer.

The op-ed authors recommend:

"The discussion should acknowledge that African-American men are at a higher risk of developing and dying from prostate cancer, that they have an increased risk for aggressive disease at diagnosis, that there are significant advancements in the detection and staging of prostate cancer, that the PSA test is just one of many available to help make an educated decision, and that the importance of seeking high-quality cancer care with supportive services and clinical trial opportunities are paramount."

7.22.2016

A dramatic rise in advanced prostate cancer has been reported by a Northwestern Medical study published in Prostate Cancer and Prostatic Diseases, July 19, 2016, a Nature journal.

The study shows a 72% increase in new cases of metastatic prostate cancer in the past decade from 2004 to 2013. The study discusses two possible causes for the increase — a recent trend of fewer men being screened and that the disease has become more aggressive.

“One hypothesis is the disease has become more aggressive, regardless of the change in screening,” said senior study author Dr. Edward Schaeffer, chair of urology at Northwestern University Feinberg School of Medicine and Northwestern Medicine. “The other idea is since screening guidelines have become more lax, when men do get diagnosed, it’s at a more advanced stage of disease. Probably both are true. We don’t know for sure but this is the focus of our current work.“

“The results indicate that screening guidelines and treatment need to be refined based on individual patient risk factors and genetics,” said lead author Dr. Adam Weiner, a Feinberg urology resident. “This may help prevent the growing occurrence of metastatic prostate cancer and potential deaths associated with the disease. This also can help minimize overdiagnosing and overtreating men with low-risk prostate cancer who do not need treatment.”

“Prostate cancer is 100 percent treatable if detected early, but some men are more likely to develop aggressive disease that will recur, progress and metastasize,” said Dr. Jonathan W. Simons, president and CEO of the Prostate Cancer Foundation.

“Not all men with prostate cancer need immediate surgery or radiation. But every case needs precision prostate cancer care. We urgently need smarter and more targeted cancer screening, so we don't leave men at highest cancer risk unprotected from early, curable disease being missed and turning into incurable disease,” said Simons.

7.12.2016

What leads cardiac patients to file medical malpractice lawsuits? According to a review of 429 cardiology claims that closed between 2007 and 2013 by The Doctors Company — a physician-owned medical malpractice insurer — the most common reason is diagnosis related. That is, either a failure to diagnose, a delay in diagnosis, or a wrong diagnosis.

A brief summary of the top 5 reasons for the lawsuits (as reviewed by the insurer) are:

6.10.2016

The Massachusetts Appeals Court has upheld a $16.7M judgment from June, 2014, in a wrongful death medical malpractice lawsuit involving misdiagnosed lung cancer. The lawsuit was brought by the daughter of a 47-year-old woman who died from a 13-month delay in diagnosis of lung cancer at Brigham and Women's Hospital, where a radiologist failed to identify and report a 1-1.5cm nodular density in the upper part of the right lung.

Attorneys Robert Higgins and Barrie Duchesneau represented the plaintiff at trial. After 3 hours of deliberations, the jury returned a
verdict against the radiologist for negligence in care and treatment for $11,000,000. The jury awarded $1,000,000
for conscious pain and suffering, $3,000,000 for the plaintiff’s loss of
consortium up to the time of the verdict and $7,000,000 for the
plaintiff’s loss of consortium into the future. The total judgment was
$16,764,603 after the addition of pre-verdict statutory interest.

4.27.2016

When the U.S. Food and Drug Administration (FDA) announced last week a proposal to
ban electrical stimulation devices (ESDs), it was a long awaited final chapter in a lawsuit brought by Lubin & Meyer on behalf of Cheryl McCollins whose son Andre had been severely injured due to repeated electrical shock treatments while a student at the Judge Rotenberg Center.

"Many children and families have long awaited this historic news," said Benjamin Novotny, who represented McCollins at trial. "It is encouraging that the FDA is following the United Nations' footsteps and labeling this practice for what it is, torture."

The disturbing video evidence presented at trial, helped to reach a settlement, mount public outrage and move an FDA panel to hold a hearing to consider banning the practice of aversive electronic shock treatments. That hearing led to a recommendation to ban the practice, and now — two years later — the FDA has issued a proposal to ban the devices.

"The FDA takes the act of banning a device
only on rare occasions when it is necessary to protect public health.
ESDs administer electrical shocks through electrodes attached to the
skin of individuals to attempt to condition them to stop engaging in
self-injurious or aggressive behavior. Evidence indicates a number of
significant psychological and physical risks are associated with the use
of these devices, including depression, anxiety, worsening of
self-injury behaviors and symptoms of posttraumatic stress disorder,
pain, burns, tissue damage and errant shocks from a device malfunction.

In addition, many people who are exposed to these devices have
intellectual or developmental disabilities that make it difficult to
communicate their pain or consent. As these risks cannot be eliminated
through new or updated labeling, banning the product is necessary to
protect public health."

ATTORNEY ADVERTISING: This information is provided for informational purposes only and does not offer legal advice. Use of this web site or e-mail does not establish an attorney-client relationship. Past performance does not guarantee future results.